Proof of Loss Sample Clauses

Proof of Loss. For Covered Services provided by Contracting Providers, Preferred and Participating Dentists, Contracting Vision Providers, and Contracting Pharmacies, Members are not required to submit claims in order to obtain benefits. For Covered Services provided by Non-Contracting Providers, Non-Participating Dentists, Non-Contracting Vision Providers, and Non-Contracting Pharmacies, Members must furnish written proof of loss, or have the provider submit proof of loss, to CareFirst BlueChoice within one (1) year after the date of the loss. The Member is also responsible for providing information requested by CareFirst BlueChoice including, but not limited to, medical records. Failure to furnish proof within the time required shall not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time, provided proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one (1) year from the time proof is otherwise required. CareFirst BlueChoice will honor claims submitted for Covered Services, Covered Dental Services, or Covered Vision Services by any agency of the federal, state, or local government that has the statutory authority to submit claims beyond the time limits established under this In-Network Agreement. These claims must be submitted to CareFirst BlueChoice before the filing deadline established by the applicable statute on claims forms that provide all of the information CareFirst BlueChoice deems necessary to process the claims. CareFirst BlueChoice provides forms for this purpose.

Proof of Loss. In the event the Company is unable to determine the amount of loss or damage, the Company may, at its option, require as a condition of payment that the Insured Claimant furnish a signed proof of loss. The proof of loss must describe the defect, lien, encumbrance, or other matter insured against by this policy that constitutes the basis of loss or damage and shall state, to the extent possible, the basis of calculating the amount of the loss or damage.

Proof of Loss. You must submit a detailed written proof of loss within one hundred twenty days

Proof of Loss. The Insured must provide proof of Loss, including such evidence as the Insurer reasonably determines is necessary to prove the Loss. If the Insured does not provide such evidence within six (6) months of the date of the Insurer’s request, then the Insurer may deem the claim withdrawn and shall not pay the Loss. The Insured shall not submit another claim based upon the same Loss.

Proof of Loss. The prepayment agency reserves the right at its discretion to accept, or to require verification of, any alleged fact or assertion pertaining to any claim for Dental Expense Benefits. As part of the basis for determining benefits payable, the prepayment agency may require x rays and other appropriate diagnostic and evaluative materials.

Proof of Loss. For Covered Services provided by Preferred Providers, Preferred and Participating Dentists, Contracting Vision Providers, and Contracting Pharmacies, Members are not required to submit claims in order to obtain benefits. For Covered Services provided by Non-Preferred Providers, Non-Participating Dentists, Non-Contracting Vision Providers, and Non-Contracting Pharmacies, Members must furnish written proof of loss, or have the provider submit proof of loss, to CareFirst within one (1) year after the date of the loss. The Member is also responsible for providing information requested by CareFirst including, but not limited to, medical records. Failure to furnish proof within the time required shall not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time, provided proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one (1) year from the time proof is otherwise required. CareFirst will honor claims submitted for Covered Services, Covered Dental Services, or Covered Vision Services by any agency of the federal, state, or local government that has the statutory authority to submit claims beyond the time limits established under this Agreement. These claims must be submitted to CareFirst before the filing deadline established by the applicable statute on claims forms that provide all of the information CareFirst deems necessary to process the claims. CareFirst provides forms for this purpose.

Proof of Loss. You must submit to us a proof of loss (sworn to by you if requested) within 60 days after the loss or accident containing the following information: a. the time, place and circumstances of loss; b. your interest and the interests of all others in the property involved, including all mortgages and liens on the covered property; c. other policies of insurance that may cover the loss on the property; d. changes in title or occupancy of the property during the policy period; e. available plans and specifications of buildings or structures; f. detailed estimates for repair of the damage; and g. if requested, an inventory of damaged personal property showing in detail the quantity, description, cost, actual cash value and amount of loss. You must attach to the inventory copies of all bills, receipts and related documents that substantiate the inventory.

Proof of Loss. 1. Written proof of loss must be furnished to the Company at its said office, within ninety days after the date of such loss. 2. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one year from the time proof is otherwise required.

Proof of Loss. Written proof of loss must be furnished to Us within thirty (30) days from the date of issuance of Our receipt of the claim form provided to Us. Failure to furnish such proof within the specified time frame shall not invalidate any claims if it was not reasonably practicable to provide proof within such time, provided that such proof is furnished as soon as reasonably practicable, and in no event later than one hundred and eighty (180) days from the time when such proof is otherwise required. All certificates, information and evidence in such form and of such nature and within such time as We may reasonably require shall be furnished at the expense of the claimant without any expense to Us.

Proof of Loss. In every case of loss, the Company shall provide the Reinsurer with copies of all proofs of loss, underwriting papers, investigation reports and a statement showing the amount paid on the claim by the Company, plus any information the Reinsurer may request.